Please print a copy of your completed form prior to closing the document as it cannot be saved

							                                                                    Please print a copy of your completed form prior to closing the document as it cannot be saved.


                                                     ECU BUSINESS SERVICES
   TEXTBOOK LOAN PROGRAM APPLICATION & LOAN AGREEMENT
                    ECU-Dowdy Student Stores • (252) 328-6731 • 1-877-499-TEXT
ECU EMPLOYEE INFORMATION
LAST NAME (ECU EMPLOYEE)                                               FIRST NAME (ECU EMPLOYEE)                                      MIDDLE INITIAL


DEPARTMENT/CAMPUS MAILING ADDRESS                                      CAMPUS PHONE                              HOME PHONE

HOME MAILING ADDRESS                                                   CITY, STATE, ZIPCODE


EMAIL ADDRESS                                      BANNER ID NUMBER                                APPROXIMATE DATE EMPLOYED BY ECU


APPLYING FOR (check only one)                       FALL         SPRING             SUMMER I             SUMMER II             11-WEEK SUMMER
(separate application required for each term)

STUDENT EDUCATIONAL STATUS (CHECK ALL THAT APPLY)
  UNDERGRADUATE STUDENT OR      GRADUATE STUDENT                                             DEGREE PROGRAM OR                    NONDEGREE

STUDENT USING BOOKS INFORMATION
LAST NAME (STUDENT USING BOOKS)                                         FIRST NAME (STUDENT USING BOOKS)                              MIDDLE INITIAL



  FULL-TIME ECU EMPLOYEE WHO HAS COMPLETED PROBATION PERIOD                                               SPOUSE               DEPENDENT CHILD

LOAN AGREEMENT
CONSENT TO GARNISHMENT
     I understand that it is a privilege to participate in East Carolina University’s Business Services Textbook Loan Program and that my successful
participation in the program will contribute to its continued success and to the ability of other University employees seeking to enhance their
job skills or pursue educational goals. I agree to comply with the conditions of the ECU Business Services Textbook Loan Program and accept
full responsibility for the textbooks loaned to me under the program. I agree that the textbooks will be returned in satisfactory condition and
agree to return the textbooks within three business days following the final exam for each course, or immediately upon withdrawal from the
course or separation from the university, whichever comes first.

If the textbooks are not returned by the deadline or are not returned in a satisfactory condition, I agree to pay the full replacement costs for those
textbooks. If I fail to pay for or to replace the textbooks by the established deadline, I understand that I will no longer be eligible to participate in
the Textbook Loan Program and agree, by providing my signature below, that my wages may be garnished for the replacement costs.

I understand that I may refuse to authorize garnishment of my wages and that, if I fail to meet my responsibilities to return the books or to pay
the replacement costs for same, the university may pursue reimbursement under Chapter 143, Article 60 or other applicable provisions of the
General Statutes of North Carolina. I understand that Chapter 143, Article 60 in Section 143-553(a) provides that if I owe money to the university
because of my failure to return or reimburse the university for the books, I can be terminated from my university employment.

I acknowledge that a copy of Chapter 143, Article 60 is printed on the reverse side of this form for my reference and review. I further acknowledge
that I have read this entire Consent to Garnishment and the North Carolina statutes that are included herewith. I fully understand the Consent to
Garnishment and the consequences to me, if I fail to return the loaned textbooks by the deadline or in a satisfactory condition, and I agree to be
legally bound by this agreement.

DECLARATION OF SPOUSE / CHILD DEPENDENT (Complete this section for Dependent Child / Spouse Book Loans Only)

By signing this agreement I attest that the person named above as the student using these books is my (select one:         spouse     dependent child)
and was indeed listed as a (select one:    dependent child   spouse) on my most recent tax return.

Employee Signature _______________________________________________                            Date ________________________



LOAN PROGRAM DEADLINES & REQUIREMENTS

• This completed application along with a copy of your Complete Textbook Listing from OneStop AND a copy of your paid
receipt for payment of classes from Banner or OneStop MUST be emailed to TEXTBOOKLOAN@ecu.edu or returned to the
Dowdy Student Stores Main Campus location (Wright Building) or to the Medical Bookstore (Brody Building) by the posted
deadline. Please refer to our web site: www.ecu.edu/cs-admin/studentstores/TextbookLoan (faculty/staff info) for more details.

• If submitting paperwork close to the beginning of the term for which you are applying, please allow 3 business days to
process before picking up books.

• Loaned materials MUST be returned within 3 business days following the final exam for the course, or immediately upon
withdrawal from the course, or separation from the university.

                                                                                                                                                 BSM 07/09
                             Summary of Chapter 143, Article 60
                          Of the General Statutes of North Carolina

Chapter 143, Article 60, in Section 143-553(a) of the General Statutes of North Carolina,
provides that if you are employed by a State Agency and you owe money to the State, you must
make full restitution of the amount you owe as a condition of your continued employment. East
Carolina University is a state institution of higher education and a state agency. That means that
if you owe money to the University and you fail to pay the money you owe, the University may
take action to terminate your employment.

However, you may not be terminated if there is a genuine dispute about whether you owe money
to the State or how much money you owe to the State. Also, you may not be terminated if there
is an unresolved issue concerning insurance coverage, or if you are pursuing administrative or
judicial remedies to have the dispute or the issue resolved. Although you will not be terminated
as long as you continue to make repayments to the State in good faith on a schedule agreed to
by the University, the University may terminate you if you stop making payments.

Section 143-554 provides you with the opportunity to appeal your termination to the State
Personnel Commission according to the normal appeal and hearing procedures provided by
Chapter 126 and the State Personnel Commission. You may wish to consult with the Employee
Relations Officer at 328-0017 to fully understand your appeal rights and the deadlines that may
apply for filing an appeal.




        Current ECU 1 Card and approved form required for merchandise pickup.

 RETURN LOANED MATERIALS WITHIN 3 BUSINESS DAYS FOLLOWING THE FINAL
EXAM FOR THE COURSE, OR IMMEDIATELY UPON WITHDRAWAL FROM THE COURSE
          OR SEPARATION OF EMPLOYMENT FROM THE UNIVERSITY.